Thursday 22 August 2019

Up to half of youth with diabetes skip their clinics

Up to 50pc of young patients are not attending diabetic clinics
Up to 50pc of young patients are not attending diabetic clinics

Caroline Crawford

The current care model for young adults with diabetes is "broken", with up to 50pc of young patients not attending clinics, according to a specialist in the field.

Professor Seán Dineen, head of the School of Medicine at NUI Galway, said young adults struggled to accept the condition and this was being exacerbated by current care provision, which is hospital-based.

He said the non-attendance rate at his diabetes clinic was an average of 30pc, rising to as high as 50pc.

Young sufferers were failing to follow through on their care and ending up with "life-changing consequences". Some died as a result, he added.

Prof Dineen, a consultant endocrinologist, called for a review of the current care plan on offer. He said a proper model needs to take into account the needs of young diabetics and also address the mental-health aspects of their condition.

"It's a time in the life cycle when being similar is probably one of the most important things. And this condition really makes you different and some of our young adults really struggle with that.

"They end up with life-changing consequences as a result of poor blood-sugar control during the young adult period.

"Some of them die as a result of the combination of risk taking, which is part of the young adult experience, and living with type 1 diabetes.

"Those of us involved in delivering care to this group, feel each time we deliver a clinic that we're not doing a good job.

"The reason we feel this a lot of the time is our non-attendance rate, not to mind non-adherence, but non-attendance rate is 30pc and sometimes as high as 50pc.

"To me that says the model of care is broken and we need to figure out a different way of engaging with this group of individuals."

Speaking at the Frontiers in Healthcare Conference in NUI, Galway, Prof Dineen said a "re-imagining" of young adult diabetes care was needed.

"The way we are doing it now, in my opinion it isn't working well," he argued.

He pointed to data from the UK, which shows that men aged 15-34 living with the illness have a three to fourfold increased risk of death, with this rising to a nine-fold risk for young women in the same category.

The young diabetes clinic in Galway is now liaising with Jigsaw, a youth mental-health service in the city, to review how care is delivered to this age group.

"We haven't figured this out but this is an exciting venture. A lot of the issues our young adults struggle with are mental health issues, in my opinion. They struggle with having this condition that makes them feel different," said Prof Dineen.

He said a solely hospital setting for all young diabetic care should be reviewed.

"This model of hospitals was set up for acute illnesses, chronic disease management. There are things done well in a hospital setting - screening the eyes, kidneys and feet for example and that's an important part of diabetes care.

"But in terms of supporting people to live well with a condition that doesn't go away, ever - you can't get a weekend off of this thing - I don't think hospitals are the best way."

He also called for greater emphasis on the psychological side of the illness.

Irish Independent

Editor's Choice

Also in Irish News